Cavernous carotid aneurysms are considered benign lesions with indolent natural history. Apart from idiopathic aneurysms, traumatic, iatrogenic and mycotic aneurysms are common in the cavernous segment of carotid artery. With rapid advances in endovascular therapy, management of cavernous carotid aneurysms has evolved over the years. Our aim was to review ...

Vourliotakis George G Department of Surgery (Division of Vascular Surgery), 401 General Military Hospital of Athens, Athens, - - 2014

Complex iliac anatomy including extreme tortuosity constitutes a relative contraindication for endovascular abdominal aortic aneurysm repair with additional risk of limb-graft occlusion. The Gore Excluder limb-graft is a flexible stent-graft, which adapts easily to iliac tortuosity. Nevertheless, the presence of the stiff guide wire does not always allow for an ...

Recently, researchers have shown an increased interest in the biomechanical modelling of cerebral aneurysm development. In the present study a fluid-solid-growth model for the formation of a fusiform aneurysm has been presented in an axi-symmetric geometry of the internal carotid artery. This model is the result of two parallel mechanisms: ...

Mitral valve repair is the gold standard treatment for mitral regurgitation. The history of mitral valve repair and its refinement in terms of the technique used will show the evolution of this surgical technique. The standard technique we use for mitral valve repair is described, and the outcomes we have ...

Sorkin Grant C GC Departments of *Neurosurgery, §Radiology, and ¶Neurology, School of Medicine and Biomedical Sciences, and ‖Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York; ‡Department of Neurosurgery, Gates Vascular Institute, Kaleida Health Buffalo, New York; #Jacobs Institute, Buffalo, New - - 2014

: Endovascular technique represents an important, minimally invasive approach to treating cerebrovascular disease. In this article, we discuss the origins of endovascular neurosurgery as a discipline in the context of important technical milestones, evidence-based medicine, and future cerebrovascular neurosurgical training. Cerebrovascular neurosurgery has seen a steady, convergent evolution toward the ...

We sophisticate a fluid-solid growth computational framework for modelling aneurysm evolution. A realistic structural model of the arterial wall is integrated into a patient-specific geometry of the vasculature. This enables physiologically representative distributions of haemodynamic stimuli, obtained from a rigid-wall computational fluid dynamics analysis, to be linked to growth and ...

The vertebral artery (VA) bilaterally arises usually from the subclavian artery and courses within the bony canals of cervical vertebrae, and then it reverses directions on the first vertebra before piercing the dura to enter the cranium.The aim was to follow (ab)normal developmental changes of extracranial VA from prenatal status ...

We present a case of an arch anomaly in a 54-year-old female who was admitted to our hospital for magnetic resonance angiography (MRA) to evaluate her right-sided numbness. MRA revealed a truncus bicaroticus, right common carotid artery (CCA) originating right vertebral artery, right subclavian artery arising as the final branch ...

Spontaneous rupture of an aneurysm of the ovarian artery is usually considered a rare complication of pregnancy and the puerperium. However, we observed this emergent condition in a 51-year-old postmenopausal woman. We report here our experiences and consider lessons about diagnosis and management that can be drawn from this case ...

We present the case of a 65-year-old man with an atypical presentation of pulmonary embolism (PE) as ST elevation myocardial infarction (STEMI) with high troponin. He presented with acute exertional dyspnoea without chest pain. Since the initial ECG showed ST elevation anteroseptal (V1-V4) with concomitant deep Q waves, a delayed ...

This study reports the differences in evolution and course of multiple pseudoaneurysms (PAs) and an axillary arteriovenous fistula (AVF) after penetrating vascular trauma due to shotgun injury to the head and neck. We describe the unusual case of a young man who, following penetrating shotgun injuries to the head and ...

The CoreValve Evolut R with EnVeo R delivery catheter is a novel transcatheter heart valve (THV) system with enhanced features that have the potential to improve the safety of transcatheter aortic valve implantation (TAVI). The newly designed delivery catheter is 14 Fr-equivalent and thus expands the option of transfemoral TAVI ...

The Excluder stent graft (W.L. Gore and Associates, Flagstaff, AZ) is one of the most frequently used devices for endovascular abdominal aortic aneurysm repair and offers the advantage of a simple and reliable deployment mechanism. We report an unexpected complication during deployment of an Excluder limb graft; the "rip cord" ...

Balloon floatation pulmonary artery catheters (PACs) have been used for hemodynamic monitoring in cardiac, medical, and surgical intensive care units since the 1970s. With the availability of newer noninvasive diagnostic modalities, particularly echocardiography, the frequency of diagnostic pulmonary artery catheterization has declined. In this review, the evolution of PACs, the ...

Surgical treatment for angina pectoris was first proposed in 1899. Decades of experimental surgery for coronary artery disease finally led to the introduction of coronary artery bypass grafting (CABG) in 1964. Now that we are approaching 50 years of CABG experience, it is appropriate to summarize the advancement of CABG ...

An intracranial in situ side to side posterior circulation procedure is performed infrequently. The scope of treatment modalities of vertebral artery-PICA aneurysms and vertebral dissections is limited due to the lack of many representations of this procedure's technical nuances. To demonstrate the technical nuances of a PICA-PICA side to side ...

Aortic dissection is a challenging medical and surgical problem. Its evolution depends on size and location of its intimal tears. We describe a case of contrast enhanced MD-CT with low out flow of the false lumen for an unbalanced between the entry and the reentry tears. This determined a delayed ...

Animal models may explain how stents and flow diverters (FDs) may succeed or fail to treat bifurcation aneurysms. In vitro studies were designed to anticipate device deformations in bifurcations. Large, wide-necked bifurcation aneurysms were constructed in 21 animals and treated 4-8 weeks later using stents and FDs in various combinations, forming ...

Coronary artery bypass grafting (CABG) is the one of the most effective revascularization strategies for patients with obstructive coronary artery disease. Total arterial revascularization using one or both internal thoracic and radial arteries has been shown to improve early outcomes and reduce long-term cardiovascular morbidity. Although CABG has evolved from ...

We report a case of retroesophageal right subclavian artery identified in a 59-year-old Japanese female during routine dissection in Nagasaki University School of Medicine. This kind of variation is relatively rare; however, reports of such cases have accumulated. We paid attention to the intersegmental arteries and above all, the second ...

High vein density (DV ) evolution in angiosperms represented a key functional transition. Yet, a mechanistic account on how this hydraulic transformation evolved remains lacking. We demonstrate that a consequence of producing high DV is that veins must become very small to fit inside the leaf, and that angiosperms are ...

Currently, it remains controversial how vascular endothelial progenitor cells (angioblasts) establish their arterial or venous fates. We show using zebrafish that the arterial progenitors of the major axial vessels originate earlier and closer to the midline than the venous progenitors. Both medial and lateral progenitor populations migrate to distinct arterial ...

It has been shown that tiny gas nanobubbles form spontaneously on a smooth hydrophobic surface submerged in water. These nanobubbles were shown to be the source of gas micronuclei from which bubbles evolved during decompression of silicon wafers. We suggest that the hydrophobic inner surface of blood vessels may be ...

The morphogenesis of lobular restructuring to liver cirrhosis in nonalcoholic steatohepatitis (NASH) is yet to be clearly understood. Therefore, we observed tissue samples from three biopsies and one autopsy with NASH in the non-cirrhotic stage three-dimensionally to elucidate the evolution of fibrosis and the changes of angioarchitecture. Histologic reconstructions revealed ...

To describe the cases of percutaneous valve failure following implantation of the Medtronic Melody™ and the Edwards Sapien™ valve in the tricuspid position. There have been recent reports of the use of percutaneously delivered valves to manage failing bioprosthetic tricuspid valves. Total patient numbers remain small and follow-up times are ...

Endovascular treatment of direct carotid cavernous fistula (CCF) can be performed by either arterial or venous approaches. The aim is to disconnect the fistula with or without preservation of the internal carotid artery (ICA). The aim of this article is to describe a technique for embolization of the cavernous sinus ...

We sought to characterize UK-wide balloon aortic valvuloplasty (BAV) experience in the TAVI era. BAV for acquired calcific aortic stenosis is in a phase of renaissance, largely due to the development of transcatheter aortic valve implantation (TAVI). Data from 423 patients at 14 centers across the UK were analyzed. Patients ...

A 77-year-old man presented with 2 episodes of waking up with symptoms of vertebrobasilar ischemia (figure, A and B) within 6 months. A CT angiogram showed narrowing of the right vertebral artery due to extrinsic compression by an osteophyte of the superior articular process of the fourth cervical vertebra, compromising ...

The lungs of birds have long been known to move air in only one direction during both inspiration and expiration through most of the tubular gas-exchanging bronchi (parabronchi). Recently a similar pattern of airflow has been observed in American alligators, a sister taxon to birds. The pattern of flow appears ...

Background: In spite of its common occurrence, the factors predictive of the rupture of intracranial aneurysms (IAs) remain poorly defined. Method: A retrospective analysis of patients admitted with a primary diagnosis of cerebral aneurysm in a single institution was done. The factors studied were age, sex, size, site, side, multiplicity, ...

Surgical procedures for the treatment of complex aortic arch pathology remain among the most challenging cardiovascular operations, incurring considerable risk for death and stroke. The purpose of this article is to describe the evolution of our approach to open repair of the aortic arch. Our arterial cannulation strategy has shifted ...

The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's ...

The sites of origin of the branches of the subclavian artery depict numerous anatomical variations. However, a common trunk of the internal thoracic artery (ITA) and thycocervical trunk (TCT) arising from the vertebral artery is a rare anatomical finding. Herein, we present the first case in which the common trunk ...

Wan William W The George W. Woodruff School of Mechanical Engineering, The Wallace H. Coulter Department of Biomedical Engineering, The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, - - 2013

Elastin fragmentation is a common characteristic of vascular diseases, such as abdominal aortic aneurysms, peripheral arterial disease, and aortic dissection. Examining growth and remodeling in the presence of dysfunctional elastic fibers provides insight into the adaptive or maladaptive changes that tissues undergo in compensating for structural deficiencies. This study used ...

The purpose of this article is to review studies of aneurysm risk factors and the suggested hypotheses that connect the different risk factors and the underlying mechanisms governing the aneurysm natural history. The result of this work suggests that at the center of aneurysm evolution there is a cycle of ...

This second report in the series on coronary artery bypass presents the authors experience and personal views on the internal thoracic artery (ITA) which date to 1966. There has been a very gradual evolution in the acceptance of this conduit which was initially compared with the saphenous vein and viewed ...

Intracranial vertebral artery dissection (VAD) represents the underlying etiology in a significant percentage of posterior circulation ischemic strokes and subarachnoid hemorrhages. These lesions are particularly challenging in their diagnosis, management, and in the prediction of long-term outcome. Advances in the understanding of underlying processes leading to dissection, as well as ...

Treatment of complex middle cerebral artery (MCA) aneurysms often requires vessel sacrifice or prolonged temporary occlusion with extra- to intracranial (EC-IC) bypass to preserve perfusion. A crucial surgical step is the identification of the bypass recipient artery matching the distal territory of the involved vessel. To report about the feasibility ...

In 1953 Frank Low published the first high-resolution electron micrographs of the human pulmonary blood-gas barrier. These showed that a structure only 0.3 μm thick separated the capillary blood from the alveolar gas, immediately suggesting that the barrier might be vulnerable to mechanical failure if the capillary pressure increased. However ...

Monozygotic twins are, as recently described in this journal, subject to many complications (1) including the twin reverse arterial perfusion sequence (TRAP) which has an incidence between 0.3 and 1%. Arrested cardiac development within the abnormal twin and failure of the heart due to reverse perfusion by the co-twin through ...

The aim of this study was to assess the efficacy of stent-based delivery of succinobucol alone and in combination with rapamycin in a porcine coronary model. Current drugs and polymers used to coat coronary stents remain suboptimal in terms of long term efficacy and safety. Succinobucol is a novel derivative ...

The metabolic and haemodynamic changes associated with chronic kidney disease result in accelerated arterial stiffening which in part explains the high cardiovascular risk associated with this condition. Measurement of arterial stiffness is a useful tool for studying cardiovascular pathophysiology and effects of therapies. Performed well, these techniques are an accurate ...

Pulmonary arterial hypertension (PAH) is a disorder characterized by increased pulmonary vascular resistance and mean pulmonary artery pressure leading to impaired function of the right ventricle, reduced cardiac output, and death. An imbalance between vasoconstrictors and vasodilators plays an important role in the pathobiology of PAH. Nitric oxide (NO) is ...

The purpose of this anatomic study was to determine the extent of lateral dissection that can be performed during anterior cervical decompression and fusion to maximize decompression without compromising the vertebral arteries. Although vertebral artery injury is rare, it is sometimes catastrophic and leads to significant morbidity and mortality. Previous ...

The knowledge on the arterial variations in the arm is of importance for a clinician, as it is a frequent site of injury and as it is also involved in many surgical and invasive procedures. During the routine dissection classes for medical students, we came across the multiple arterial variations ...

Abdominal aortic aneurysms (AAAs) are a common but asymptomatic disease that has high susceptibility to rupture. Current therapeutic options are limited to surgical procedures because no pharmacological approaches have been proven to decrease either expansion or rupture of human AAAs. The current dearth of effective medical treatment is attributed to ...

Pulmonary embolism is a common, often fatal condition that requires timely recognition and rapid institution of therapy. Previous studies have documented worse outcomes for weekend admissions for a variety of time-sensitive medical conditions. This phenomenon has not been clearly demonstrated for pulmonary embolism. We used the Healthcare Cost and Utilization ...

Advances in the endovascular treatment of intracranial aneurysms since the advent of detachable coil embolization continue to expand the spectrum of lesions amenable to minimally invasive therapy. The feasibility of treating a given cerebral aneurysm by a given open or endovascular modality does not necessarily make such an approach the ...